ABSTRACT
PURPOSE: To compare bone mineral density (BMD) in patients with or without weekly injection of teriparatide to promote bone ingrowth after cementless total knee arthroplasty (TKA). METHODS: Records of 8 men and 32 women (mean age, 75.6 years) who underwent cementless TKA for medial knee osteoarthritis with (n=20) or without (n=20) once-weekly subcutaneous/hypodermic injection of teriparatide for 48 weeks were reviewed. BMD and bone volume/total volume (BV/TV) of the bone-prosthesis interface of the proximal tibia in 6 regions of interest (ROI) were assessed at 3, 6, 9, and 12 months using multi-detector computed tomography. RESULTS: Patients with or without weekly injection of teriparatide after cementless TKA were comparable in terms of baseline characteristics and pre- and post-operative knee range of motion and Knee Society knee and function scores. In ROI 1 (medial), ROI 3 (anteromedial), and ROI 4 (posteromedial), the BV/TV increased throughout the postoperative period in patients with weekly injection of teriparatide and declined after 6 months in patients without weekly injection of teriparatide. These 3 ROIs of the 2 groups differed significantly only in BMD at 6, 9, and 12 months. In ROI 2 (lateral), ROI 5 (anterolateral), and ROI 6 (posterolateral), both BV/TV and BMD showed a decreasing trend, and these 3 ROIs of the 2 groups did not differ significantly. CONCLUSION: Weekly injection of teriparatide after cementless TKA promoted bone ingrowth mostly in the medial aspect of the bone-prosthesis interface.
Subject(s)
Arthroplasty, Replacement, Knee , Bone Density Conservation Agents/administration & dosage , Bone Density , Osteoarthritis, Knee/surgery , Teriparatide/administration & dosage , Aged , Aged, 80 and over , Drug Administration Schedule , Female , Follow-Up Studies , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
A new morphometry system for submicroscopic three-dimensional structures was developed on the same principles as for the aerial survey using SEM stereo-pairs. This computer graphic system was applied to the analysis of the surface features of the intestinal mucosa. After removing the epithelial layer by prolonged osmication, core structures of the intestinal villi were exposed and 100 villi each from rat and mouse were measured. Average height, basal area and surface area of a single core of the rat were 188 microns, 20,200 microns2 and 93,500 microns2, respectively. Those of the mouse were 148 microns, 7,530 microns2 and 37,100 microns2, respectively. Surface amplifications by the rat and the mouse villi, after compensating for epithelial thickness, were calculated as 3.5 and 4.3, respectively; though amplifications based on the villous core were 4.6 and 4.9, respectively. These three-dimensional features of the intestinal mucosa were illustrated as submicroscopic maps by drawing their contour lines. It was demonstrated that the present morphometry system makes it possible to know not only the average features of a large sample, but also a variety of features of individual structures which were directly observed under SEM.
